Palliative medicine
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Palliative medicine · Mar 2007
ReviewFeeling like a burden to others: a systematic review focusing on the end of life.
Research into the burden of illness has focused predominantly on family caregivers, with little consideration of the other side of the caregiving relationship-care recipients' perspectives on having become a 'burden to others'. However, there is now a small but growing body of evidence to suggest that worry about creating burden to others is a common and troubling concern for people who are nearing the end of their lives. This concern is referred to as 'self-perceived burden'. ⋯ It is correlated with loss of dignity, suffering, and a 'bad death'. Self-perceived burden has also been identified as a relevant factor in death-hastening acts among patients with life-threatening illness, as well as in clinical decisions, such as the choice of place of care at the end of life, advance directives, and acceptance of treatment. Given the unique challenges faced by patients with advanced disease and their families, there is a need for further investigation into this under-researched area.
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Palliative medicine · Mar 2007
Respiratory function during parenteral opioid titration for cancer pain.
Respiratory depression is the most feared opioid-related side-effect yet research on the topic is sparse. We evaluated changes in respiratory parameters during parenteral opioid titration for cancer pain to determine if opioid titration was associated with evidence of hypoventilation. The primary outcome measure was to measure changes in end-tidal CO(2) (ET-CO(2)) during opioid titration to pain control. ⋯ Parenteral opioid titration for relief of cancer pain was not associated with respiratory depression as demonstrated by significant changes in ET-CO(2) or oxygen saturation in non-oxygen dependent cancer patients.
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Palliative medicine · Mar 2007
Fighting a losing battle: eating-related distress of men with advanced cancer and their female partners. A mixed-methods study.
Anorexia/cachexia is a frequent complication of advanced cancer with poorly understood psychosocial impact or eating-related distress (ERD) on both patients and family members. To assist palliative care practitioners manage this important psychosocial aspect of care, we aimed to discover and describe elements of ERD, focusing on male patients with advanced cancer and their female partners. ⋯ Anorexia/cachexia of male cancer patients affects the cooking at home, a couple's daily eating routines, and their spousal relationship. Identification of ERD may trigger targeted psychosocial interventions.
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Palliative medicine · Mar 2007
The value of cognitive interviewing techniques in palliative care research.
In answering questionnaires, research participants undertake complex cognitive processes, including understanding/interpreting questions, retrieval of information from memory, decision processes to estimate answers and response formulation. Cognitive interviewing techniques are widely used in large surveys, to improve questionnaires by understanding these processes, but their use is less familiar in other areas of palliative research. ⋯ Cognitive interviewing was able to helpfully identify the range and depth of difficulties with questions, to a greater degree than with standard piloting. It may be of particular benefit when instruments are used in different combinations, or applied to new study populations. Wider use of these techniques in palliative research is recommended.